Ted McFerrin Story – February 2006

Ted McFerrin lost his courageous battle with pancreatic cancer on August 17, 2007.

Background

I have been a Professor of English at Collin County Community College in Plano, Texas since 1988 and am married to Carolina Dizon McFerrin. I have one daughter, Laura McFerrin, who is 30. On my 59th birthday, May 1, 2005, ironically, I went to my family cemetery for the yearly decoration day. I was also making a decision about where my grave would be located, although I had no indication I would need it any time soon. I awoke with what I thought was a severe kidney infection. By the next day, I had developed jaundice, which worsened rapidly until my whole body was a bright yellow. My primary care physician, Dr. James Hinton III, suspected gallstones and referred me to the first of many specialists, Dr. Kenneth Brown, a Gastroenterologist, and he and Dr. Goldschmidt performed an ERCP. However, they found cancer blocking my bile duct. They inserted a plastic stent to open the duct and relieve the blockage and referred me to a surgeon, Dr. G. T. Shires, at Presbyterian Hospital in Dallas based on my CT. I was told my condition was very serious. I managed to finish my spring classes, helped by substitutes, but was too sick to attend graduation, for the first time in 18 years. I wanted to teach summer school, as I usually did, but was too ill.

Treatment

In the next four weeks, I had two more endoscopic procedures, with a metal stent replacing the plastic one and an EUS. There was no evidence the cancer was spreading to organs or other sites. My appetite was poor, and I felt sick at my stomach with pain in my right side. I eventually lost over fifty pounds–over one third of my body weight. On June 10, Dr. Shires attempted a Whipple. I woke up out of pain for the first time in a month, but to bad news. He was unable to remove the cancer because it was involved with arteries. He did remove my gall bladder. After a week of rapid recovery, I was discharged from the hospital.
I saw Dr. Shires for follow-up several times, and was referred to North Texas Regional Cancer Center in Plano. Drs. Robert Kirby and Jeffrey Greenberg, oncologists, administered chemo and radiation treatment. My CA19-9 started at 485. My radiation was each weekday for 25 days with 5FU on the first four and last four days. I was afraid, and asked my daughter Laura to drive me the first day. My tumor marker declined, to 271, 57, and finally 41 after the treatments. I was hopeful for another Whipple if the cancer declined in size, but the doctors said it was not possible because of the cancer’s size, shape, and position. By the end of the treatments, I was too weak to get off the radiation table unassisted, but was still able to drive the few miles for treatment. I loved the feeling of some independence and control.
I was nonetheless hopeful because the marker was so close to cancer free, but Dr. Kirby told me that it would be back, and my last hopes would be strong chemo and eventually treatment trials. He said that I had six months to one year to live. Weight came back to a high of 115 pounds of my usual 155, but towards the end of the treatments I was getting weaker and weaker and losing weight. The treatments ended August. 16, and I had hoped to teach fall semester after the summer off. However, that was not to be. After a hopeful start, I was feeling worse and worse and weaker and weaker. My wife was worried that I couldn’t eat and seemed to sleep most of the time. Eventually, I got so weak that I had to be helped up, like I was by the end of the radiation treatments. I was admitted to Plano Medical Center on September 20th.

Complications

I spent the next month very ill in the hospital, with two more specialists added to my growing team. The stent had become infected, and Dr. Kim put two drains in my liver for cysts that had developed. Dr. Howard Kussman, of Infectious Diseases Consultation, infused me with three antibiotics. A liter of liquid was drained from my lungs three times. At times the prognosis was very bad, and I was told I only had two days to a week to live. I was given two units of blood and was so weak I was connected to a feeding tube along with trying to eat as much as I could. Physical Therapists worked with me twice a day to begin sitting up alone, exercising, and walking again. For a time, I was diabetic and needed insulin three times a day because of the feeding tube. I was anemic.
I was released from the hospital on October 14. The hospital social worker felt I should go to a nursing home, but Dr. Kussman suggested my wife, who had spent every night by my side in the hospital, could treat me at home. She rolled me home in a wheelchair and rented a hospital bed. She learned to change my IVs for the antibiotics, clean my drains, give me an injection in my stomach each morning for blood clots, and kept me clean and fed. For weeks she slept beside me on a couch. I owe her my life and am very grateful.

Diet/Medications

Slowly, I regained strength, increasing my short walks in front of the house. I tried to eat as much as I could, and the Megestrol seemed to help. While not exactly hungry, my stomach growled every two hours like a newborn. I gave up coffee, tea, carbonated drinks, and alcohol because it seemed like a good idea. I usually felt worse after eating, probably exacerbated by lying down too soon after feeding.
At my yearly physicals, I had tried to get Dr. Hinton to say I was in pretty good shape. The year before, he said, “let’s just say you’re holding your own.” Looking back, it may not have been a good sign that my weight had stayed exactly the same for two years, regardless of diet. I was unused to taking much medication: only one pill per day, first Pravachol and then Lescol, available in a generic for my insurance, which brought my cholesterol down to acceptable limits. So the many medications I now take has been a difficult transition, but I’m getting used to it.
I was now taking hydrocodone for pain, Protonix for digestion, warfarin to prevent blood clots, Pancrease MT20 at meals and snacks for digestion, and Ambien, a sleep aid. In addition, I was going between laxatives like Glycolax and Dulcolax Stool Softener as a suppository, hydrocortisone acetate and commercial products to ease painful hemorrhoids. I was also experimenting with supplements like protein powders, Prosure, Reliv, and Xango (mangosteen). These seemed to make the painful hemorrhoids worse.

Support

My wife Lina has continued to me my primary caregiver and support. She initiated internet research that found useful resources, including this web site, and Pancreas-Onc@Listserv.acor.org, a chat line with much useful information, as well as providing a sense of not being alone with my symptoms, and hope from others who are inoperable. The PALS Associate (Patient and Liaison Services) at PanCAN (Pancreatic Cancer Action Network) at 1-877-272-6226 has been very helpful, providing publications and information–and even a purple ribbon to wear, to promote awareness of our disease.
I decided in the beginning to make my condition known at work, mainly because I knew of no other way to explain my extended sick leave (from May 2005 to January 2006). I had tried to teach the fall semester, in August. 2005, but was so weak I didn’t complete the first week. I was glad I did make my condition public, though. The response was overwhelming, from the President, Cary Israel, who was constantly attentive and concerned, much more than I ever expected or deserved, given his busy schedule; Vice-President of Academic Affairs Thom Chesney; other vice-presidents; Deans; my Dean, Gerry Perkus; Faculty; staff (Bill Kelly, Assistant to the Dean, stayed in constant touch, helping with the tasks I could no longer perform and cheering me on); and students. I received flowers, emails, visits, and cards: I have just counted them, and I received over 100 cards, with many signed with well wishes from whole departments. I can’t adequately express my profound gratitude. It helps so much to feel that others care and are concerned. My family, friends, and former shipmates (I served aboard the USS Harry E. Hubbard, DD-748 in Vietnam from 1965-67 and had to miss our yearly reunion in April) have also helped me through the difficult days and nights and lightened my burden. We are grateful for the many friends and relatives praying for us.

Conclusion

I realize like everyone that my life will end sometime, but this illness has been a blessing in several ways. I knew that I didn’t want to die suddenly, without a chance to prepare as much as I could. It has given me the chance to return to active participation in church, which I had missed, and reconciliations with family and friends as much as possible, and settling affairs. This story is one of them. My wife asked me why I was writing this now because we don’t know how the story turns out, or when. It’s because I can.
In January I went back to teaching, provided by the administration with a special schedule. I only have to be on campus for two classes, on Tuesday and Thursday mornings, with my other three classes online. I was out of sick leave, and was encouraged by Dr. Kirby and President Israel not to retire until I had to do so.
My last CT scan, in January, was hopeful. Dr. Kirby said anyone who didn’t know my past record would not have seen anything wrong. My liver was completely healed, and he did not detect any mass around my pancreas or anywhere else. I visit the doctor once a month for lab work and a visit with the doctor, keeping track of my condition. The bad news is that the CA19-9 is slowly increasing, from a low of 41, to 53, 76, and 125 on Jan. 30 2006, certainly not as bad as my initial reading of 485. Last month, I also lost two and one half pounds, down to 113. However, when I see the Doctor on March 3rd, we will discuss beginning strong chemo.
Dr. Kirby has already told me the pros and cons. He noted that I could choose to do nothing – since I am enjoying a fairly good quality of life. In the past months, my insurance company had also suggested Hospice, but I want to fight and live as long as I can. Dr. Kirby said we could wait until a mass develops somewhere, but noted that it would be harder to fight. He said one advantage to treating now is that if it is intolerable, we can afford to stop for a while or change chemos. I am studying as much as I can to find about chemo combinations. I think I want to start treatment now. My inclination all along has been to fight this thing.
The end of my story, for now, will be the first week in March when we discuss treatment options. Dr. Kirby says eventually we will run out of chemos, but I’ve learned that M.D. Anderson Hospital in Houston is aggressive in attempting second Whipple procedures, and then I want to explore clinical trials. I am not ready for that cemetery plot, yet. I set short-term goals: I made Christmas, and now I would like to see my 60th birthday on May 1st. Please pray for me as I pray for each of you and your families.
As submitted by Ted McFerrin

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Pancreatic Cancer Blog

One of the observations that physicians often made when the standard of care treatment typically consisted of the chemotherapy drug agent of gemcitabine alone, was that many patients with pancreatic cancer (ductal adenocarcinoma of the pancreas) seemed to feel better after the initiation of treatment… More Here